| Midtowne Family Practice Pllc | |
|
403 12th Street Ext Princeton WV 24740-2300 | |
| (304) 431-9998 | |
| (304) 425-0782 |
| Full Name | Midtowne Family Practice Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 403 12th Street Ext, Princeton, West Virginia |
| Authorized Official Name and Position | Pamela P. Faulkner (PHYSICIAN/OWNER) |
| Authorized Official Contact | 3044317100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midtowne Family Practice Pllc Po Box 1030 Princeton WV 24740-1030 Ph: (304) 431-7100 | Midtowne Family Practice Pllc 403 12th Street Ext Princeton WV 24740-2300 Ph: (304) 431-9998 |
| NPI Number | 1154436004 |
|---|---|
| Provider Enumeration Date | 08/20/2006 |
| Last Update Date | 04/15/2024 |
| Medicare PECOS PAC ID | 8426172115 |
|---|---|
| Medicare Enrollment ID | O20100902000030 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154436004 | NPI | - | NPPES |
| 0051816000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 1040 (West Virginia) | Primary |
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